Computer-assisted Minimally Invasive Spine Surgery Versus Minimally Invasive Spine Surgery In The Treatment Of Thoracolumbar Fractures

Objective: To compare the outcomes of computer-assisted minimally invasive spine surgery(CAMISS)and conventional minimally invasive spine surgery(MISS)in the treatment of throracolumbar fractures.Methods: A total of 41 patients with single spine fracture at the thoracolumbar level,treated with percutaneous pedicle screw fixation by posterior approach,were included between January 2014 and August 2015,and allocated to two groups.One group received CAMISS)(n=20)and another,conventional MISS.Related clinical and perioperative data were maintained in the two groups,including the time to place pedicle screws,volume of intraoperative blood loss,frequencies to start the C-arm X-ray apparatus,successful screw fixation,postoperative Visual Analogue Scale(VAS),restoration of Cobb angle and postoperative complications,and compared for assessment of the curative effects as well as advantages and disadvantages of the two techniques.Results: There was no significant difference between the two groups regarding the general clinical data obtained before surgery(P>0.05),and all patients were followed for 6 to 12 months.The difference was not significant between CAMISS and MISS techniques concerning the time consumption in placing pedicle screws,volume of intraoperative blood loss,postoperative VAS scores and restoration of Cobb angle(P>0.05),yet the difference was significant pertaining to the requirements to start the C-arm X-ray apparatus during operation and successful pedicle screw fixation(P<0.01).Conclusion: CAMISS for thoracolumbar fractures can significantly reduce the patient's exposure to the X-ray during procedure than conventional MISS,and improve the successful pedicle screw fixation as well as reduce the postoperative complications.Although CAMISS is not superior to conventional MISS with regard to the average time consumption in installation of the pedicle screws,intraoperative blood loss,postoperative VAS scores and Cobb angulation,yet it still remains a better technique to treat thoracolumbar fractures via percutaneous posterior pedicle screw fixation.